Postpartum Workshop Registration Form

Postpartum Planning Workshop Registration Details:

Please note that your information will not be distributed and will only be used to send registration links to our workshop and enter into a raffle drawing, if you would like!
Full Name*

First NameLast Name
Address*

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
How did you hear about us?*
Other*
Please check the box below to acknowledge that you are not entering into a therapeutic relationship with Melodye Phillips or Maternal Mental Health of East Texas by attending this free postpartum planning workshop. If you would like to pursue individual or group therapy, you acknowledge that you will complete separate documentation to begin the therapy relationship.

Yes, I understand
I am so excited you've made the decision to attend the postpartum planning workshop! Whether this is your first baby or your first, this workshop is designed to support you in your journey. Bring a loved one with you so they can be prepared on how to support you during the next phase of your parenting journey!

I look forward to seeing you there!

Melodye Phillips
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Postpartum Planning Workshop Registration Details: